AccountId: 011433970860
ContactId: cb6d7a81-48d1-4dc6-86d8-c86e2e6d59c0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 191320 ms
Total Talk Time (AGENT): 89633 ms
Total Talk Time (CUSTOMER): 51571 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/12/cb6d7a81-48d1-4dc6-86d8-c86e2e6d59c0_20250512T15:22_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Um, yes, hi [PII], I'm calling from Doctor [PII]'s office. I need to go over benefits on a patient, please.
[AGENT][POSITIVE] OK, I can help you with the benefits for a patient. May I please get your name and your callback number?
[CUSTOMER][NEUTRAL] Um, yes, my name is [PII], that's [PII] callback number is [PII].
[AGENT][NEUTRAL] OK and you said you were calling from [PII] and what was the last name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]. OK, thank you so much. And may I please get the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Yes, patient's name is [PII]. Policy number is 01611562 ML8. Date of birth is [PII].
[AGENT][NEUTRAL] OK, let me pull in that policy.
[AGENT][NEUTRAL] OK. Let's see, [PII].
[AGENT][NEUTRAL] I do show that [PII] does have an active policy, and the effective date of the policy is [PII], and this is just to verify benefits. It's not a guarantee of payment. This is a supplemental insurance policy that's billed secondary to the primary, and it helps with deductible, co-pay, and co-insurance.
[AGENT][NEUTRAL] The insured has an inpatient benefit amount per calendar year of $2500 and they also have an outpatient calendar year benefit amount of $1500.
[CUSTOMER][NEUTRAL] OK, so then this gap plan covers procedures up to $1500 per year.
[AGENT][NEUTRAL] Right, only for deductible, co-pay, or co-insurance.
[CUSTOMER][NEUTRAL] Right, not the, not the office is a copay. When you say copay, it's not the office is a co-pay, it's just for the uh procedures in the office.
[AGENT][NEUTRAL] Let me check and see if she has office visits or if it's just for treatment.
[AGENT][NEUTRAL] It's gonna be just a moment while I pull in the policy.
[CUSTOMER][NEUTRAL] Yeah, I don't think it is. I don't think it does. I think it just covers the procedures.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right, you're correct. Office visits are not covered under the policy, just the treatment.
[CUSTOMER][NEUTRAL] OK, great. May I have a reference number for the call?
[AGENT][NEUTRAL] Yes, ma'am. You can use my name, [PII] and today's date.
[CUSTOMER][POSITIVE] All right great thank you bye bye thanks.
[AGENT][POSITIVE] You're very welcome. You have a wonderful.